Academic Medicine最新文献

{"title":"Mentor grit as a missing element in the person × person × context framework.","authors":"Toshinori Nishizawa","doi":"10.1093/acamed/wvag300","DOIUrl":"https://doi.org/10.1093/acamed/wvag300","url":null,"abstract":"","PeriodicalId":50929,"journal":{"name":"Academic Medicine","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149118163","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"教育学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reflective ability in medical trainees: reliability and practicality of a measurement instrument and assessment in a large cohort.","authors":"Audrey DunnGalvin, Christine L Mai, Jeffrey B Cooper, George Shorten, John D Mitchell, Daniel Saddawi-Konefka, Richard H Blum","doi":"10.1093/acamed/wvag163","DOIUrl":"10.1093/acamed/wvag163","url":null,"abstract":"<p><strong>Purpose: </strong>Characterization and measurement of reflective capacity (RC), the ability to learn from experience to inform future learning and practice, in hospital trainees are critical to the design of medical education programs; testing interventions requires effective assessment. This study assessed RC among anesthesia trainees using the Reflection Evaluation for Learners' Enhanced Competencies Tool (REFLECT), which evaluates reflective writing. The study explored variation by training level, age, program, gender, and examined reliability and validity against an independent reflection measure.</p><p><strong>Method: </strong>A prospective observational study (February-May 2021) included anesthesia trainees across 4 training levels, 4 programs, and varied prior RC experience and intended subspecialties. Participants completed the REFLECT instrument (using simulated and personal events) and the Residency Level Cognitive Behavior Survey. Potential influencing factors (scenario realism, perceived importance, prior reflective writing) were examined. Data were analyzed for internal consistency (t-tests, analysis of variance, Pearson's r) and interrater reliability (Cronbach's α, intraclass correlation coefficient).</p><p><strong>Results: </strong>Participants (n = 172) demonstrated moderate RC (mean = 2.5/4, standard deviation = 0.45), with no significant differences by training level, program, gender, or age. Greater perceived realism and prior reflective writing were independently associated with higher RC. Those with prior RC training rated reflection as more important and useful. Personal and simulated event scores were similar. REFLECT showed excellent interrater reliability (Cronbach's α = 0.95) and moderate correlation with the Residency Level Cognitive Behavior Survey Reflection domain (r = 0.31, P = .001).</p><p><strong>Conclusions: </strong>REFLECT demonstrates robust psychometric properties for assessing RC in anesthesia trainees. Moderate RC scores support the need for interventions to enhance reflection. Although limited to 1 specialty and not assessing application to practice, the instrument's general structure suggests potential utility across postgraduate medical training contexts.</p>","PeriodicalId":50929,"journal":{"name":"Academic Medicine","volume":" ","pages":"1308-1314"},"PeriodicalIF":4.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148058145","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"教育学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reply to Chen et al.","authors":"Kazuya Nagasaki, Yuka Kawase, Yuji Nishizaki","doi":"10.1093/acamed/wvag297","DOIUrl":"https://doi.org/10.1093/acamed/wvag297","url":null,"abstract":"","PeriodicalId":50929,"journal":{"name":"Academic Medicine","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149118181","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"教育学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Artificial intelligence teaching assistants: a scalable solution for supporting struggling medical students.","authors":"Alina Sami, Mark Adkins, Anne McLeod, Fok-Han Leung, Chris Gilchrist","doi":"10.1093/acamed/wvag208","DOIUrl":"10.1093/acamed/wvag208","url":null,"abstract":"<p><strong>Purpose: </strong>Large language models (LLMs), such as OpenAI's ChatGPT, have demonstrated tutoring benefits in small-scale pilot studies within focused areas of medical education. This study evaluated the large-scale implementation of AI-teaching assistants (AI-TAs) within a compulsory medical school course.</p><p><strong>Method: </strong>A quasi-experimental observational study with mixed methods was conducted to assess the impact of AI-TAs in a compulsory first-year medical school course at the University of Toronto in 2024. The research team developed AI-TAs using OpenAI's ChatGPT-4o and introduced them as a supplementary resource at the course's midpoint. They analyzed exam performance among the students who used AI-TAs (n = 87) and students who did not (n = 206). Additionally, surveys (n = 18) and interviews (n = 10) explored student perceptions of AI-TAs' effectiveness, usability, and impact on learning.</p><p><strong>Results: </strong>Students who would later adopt AI-TAs had significantly lower pre-intervention exam scores than their peers [83.8% vs 88.1%; t(118.8) = -3.82, P < .001]. They also more often failed to meet the course's assessment standard pre-intervention (24.1% vs 6.4%). After AI-TA adoption, performance converged for both early users [86.1% vs 86.5%; t(95.63) = -0.35, P = .72] and late adopters [85.6% vs 86.5%; t(26.08) = -0.52, P = .61], with similar proportions falling below the course's standard (4.4%-6.4%). Thematic analysis and surveys identified 3 key advantages of AI-TAs: (1) reliable and accurate educational support, (2) efficient application across learning activities, and (3) improved psychological safety, promoting engagement in active learning.</p><p><strong>Conclusions: </strong>AI-TAs correlated with improved exam performance, fewer students in academic difficulty, and enhanced student engagement through a psychologically safe learning environment. These findings suggest that AI-TAs can serve as a scalable, cost-effective tool to support struggling students, while complementing traditional instruction.</p>","PeriodicalId":50929,"journal":{"name":"Academic Medicine","volume":" ","pages":"1265-1273"},"PeriodicalIF":4.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148377840","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"教育学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"American Board of Family Medicine Initial Certification Examination performance of 3- versus 4-year medical school graduates.","authors":"Sally A Santen, Catherine Coe, Sarah Owens, Keeley Hobart, Lars E Peterson","doi":"10.1093/acamed/wvag294","DOIUrl":"https://doi.org/10.1093/acamed/wvag294","url":null,"abstract":"<p><strong>Purpose: </strong>Three-year accelerated (A3YP) medical students graduate in three years and enter residency frequently in a directed pathway to a specific program. Some schools have found lower United States Medical Licensing Examination Step 2 scores for the A3YP graduates. There are no studies exploring if this difference extends into residency with board certification scores and pass rates. The objective of this study was to explore whether A3YP graduates have equivalent performance to traditional four-year graduates (T4YP) from similar contexts on American Board of Family Medicine (ABFM) examinations and in training examination (ITE).</p><p><strong>Method: </strong>A3YP graduates' performance from ABFM data (ITE, pass rate, initial certification examination score, score growth) were compared between A3YP graduates and all T4YP United States Medical Degree graduates of residencies who accepted any A3YP graduate from 2016 to 2021. The team conducted bivariate analysis with t-tests, Fisher exact, Chi-Square tests and Bonferroni correction was applied for multiple comparisons; statistical significance P<.006.</p><p><strong>Results: </strong>The study population was 117 A3YP and 2718 T4YP. There were not statistically significant differences between groups. A3YP graduates' intern ITE scores were slightly higher (421 vs 416, mean difference 5.57 [99.5% Confidence Limit (CL) (-14.49, 25.62)], P=.36) compared to T4YP. A3YP had a lower exam score slope (growth in scores) (30.77 vs 38.23, mean difference -7.45 [99.5% CL -16.90, 1.99], P = 0.03) resulting in a non-significant 10-point lower average performance on their Initial Certification Examination. The pass rates were similar (A3YP 100.0%,99.4% T4YP, P=.42).</p><p><strong>Conclusions: </strong>This study tested whether the length of medical school is associated with performance on ITE and board certification examination and found that there were no significant differences in performance between three-year and four-year medical school graduates in Family Medicine. This finding adds to a growing body of evidence that A3YP graduates in Family Medicine have similar outcomes to T4YP graduates.</p>","PeriodicalId":50929,"journal":{"name":"Academic Medicine","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149118116","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"教育学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"One-time introductory language experiences as gateways to longitudinal medical Spanish education.","authors":"Juli McCarroll","doi":"10.1093/acamed/wvag296","DOIUrl":"https://doi.org/10.1093/acamed/wvag296","url":null,"abstract":"","PeriodicalId":50929,"journal":{"name":"Academic Medicine","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149118132","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"教育学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Specialty‑level patterns of professionalism concerns in academic health systems: a multi‑system analysis with heat map visualizations.","authors":"Heather A Davidson, William Martinez, Thomas W Doub, Cynthia A Baldwin, Henry Domenico, William O Cooper, Gerald B Hickson","doi":"10.1093/acamed/wvag293","DOIUrl":"https://doi.org/10.1093/acamed/wvag293","url":null,"abstract":"<p><strong>Purpose: </strong>Unprofessional behavior in healthcare settings can undermine teamwork, communication, and patient outcomes. Although prior studies have shown that professionalism concerns are disproportionately concentrated among a subset of individual clinicians, less is known about specialty-level patterns. The purpose of this study was to examine whether professionalism concerns, measured using the Patient Advocacy Reporting System (PARS) risk categories, cluster at the specialty-group level within and across academic health systems (AHSs).</p><p><strong>Method: </strong>This retrospective, cross-sectional study used PARS risk categories, derived from deidentified unsolicited patient complaint data collected between March 1, 2014, and November 30, 2019. The study population consisted of 23,789 physicians representing 52 specialty groups and practicing across 19 Academic Health Systems (AHS) from multiple geographic areas regions of the United States. Physicians were categorized into high, intermediate, or low PARS risk categories. Inferential analyses used Pearson's chi-square tests to compare proportions of physicians within each risk category across specialties within the same AHS and within specialties across AHSs. Heat maps were created to visually summarize risk-category distributions.</p><p><strong>Results: </strong>Across the 19 AHSs, an average of 1.5% (n = 341) of physicians were classified as high PARS risk and 8.6% (n = 2149) as intermediate PARS risk, with substantial site-level variation. Statistically significant differences in PARS risk-category distributions across specialties were observed within 16 of 19 AHS (P<.001). Among the 23 specialties represented at all 19 AHSs, 69.6% (16/23) demonstrated significant (P<.05) between-system differences in risk-category distributions.</p><p><strong>Conclusions: </strong>The findings suggests that professionalism concerns may cluster at the specialty- group level both within and across AHSs. Routine specialty-level review, guided by statistical comparisons and complemented by heat map visualizations, may help leaders identify specialty groups and organizational contexts that warrant further evaluation to support professionalism and teamwork.</p>","PeriodicalId":50929,"journal":{"name":"Academic Medicine","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149082687","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"教育学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Defining academic physicians across health systems: a perspective from China.","authors":"Fei Zhang, Zhong Wang","doi":"10.1093/acamed/wvag298","DOIUrl":"https://doi.org/10.1093/acamed/wvag298","url":null,"abstract":"","PeriodicalId":50929,"journal":{"name":"Academic Medicine","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149082660","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"教育学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beyond applicant priorities: unintended consequences of pass/fail USMLE Step 1 on institutional equity.","authors":"Riya Mehta","doi":"10.1093/acamed/wvag299","DOIUrl":"https://doi.org/10.1093/acamed/wvag299","url":null,"abstract":"","PeriodicalId":50929,"journal":{"name":"Academic Medicine","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149082670","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"教育学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beyond learning analytics: toward learning ecosystems in artificial intelligence-enabled health professions education.","authors":"Rebekah Cole","doi":"10.1093/acamed/wvag295","DOIUrl":"https://doi.org/10.1093/acamed/wvag295","url":null,"abstract":"","PeriodicalId":50929,"journal":{"name":"Academic Medicine","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2026-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149065694","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"教育学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}